Recognition and Management of Malnutrition
2. Introduction
Book Authors
Daniel Martinez-Garcia MD | Laurent Hiffler,MD | Teresa M. Kemmer, PhD, RD | Clifton Yu, MD | Andrew J. Bauer, MD | Julia A. Lynch, MD
Introduction
Providing adequate food to meet the nutritional needs of growing children is critical to prevent an increase in malnutrition prevalence, which would lead to excess mortality during the recovery phase of a disaster. Nutritional status directly impacts the vulnerability for and the severity of infectious diseases that affect children in emergency settings. Children having frequent infections have associated anorexia, which increases the stress burden and severity of malnutrition. Previously malnourished children are particularly vulnerable, as they cannot develop the protective compensatory mechanisms that allow healthy individuals to survive during periods of food deprivation. Therefore, after disasters those children will decompensate unless given immediate nutritional support. On the other hand, good nutritional status promotes wound healing and improves the postnatal outcomes in both mothers and babies. In disaster situations, it is crucial to provide adequate food to prevent the complications associated with malnutrition. According to the World Health Organization (WHO), “food security exists when all people, at all times, have access to sufficient, safe and nutritious food to meet their dietary needs and food preferences, and to maintain an active and healthy life.”
Doctors and nurses and nutrition specialists and epidemiologists in the local community are an invaluable source of information regarding the predisaster nutritional status of the pediatric population. Their involvement in nutritional assessments and food resource planning is essential. During an assessment, recognize that large variations in baseline pediatric nutritional status can be found in a particular region. In addition, a paradoxical association of malnutrition and obesity can be found within the same household, especially in developing countries and in low-income groups. Micronutrient deficiencies, most importantly iron deficiency anemia, can be identified even in areas where the overall nutritional status is good.